Use of Sorafenib in FLT3-Mutant Myeloid Sarcoma: A Case Report

A 53-years old man with FLT3-ITD-mutant Acute Myeloid Leukemia relapsed ten months after hemopoietic allogeneic stem cell transplant as multiple cutaneous Myeloid Sarcomas. Molecular testing was performed on the core-needle biopsy of the lesion and since positive for the FLT3 mutation, a targeted-therapy with the tyrosine kinase inhibitor sorafenib as single agent was started, obtaining a sustained complete response. After 18 months of therapy patient relapsed on the previously involved sites, because of acquisition of sorafenib-resistant mutation and switched to systemic therapy. Sorafenib proved to be able to distribute in skin and subcutaneous tissues and could be safely used. Molecular testing on Myeloid Sarcoma can be therefore an innovative and effective approach in the management of extra medullary leukemia.